Posts Tagged ‘neurologist’

by Teresa LeYung-Ryan

This is 4 of 4 of my blog posts entitled “Parkinson’s Disease, My Chinese Papa, and My practicing The Four Agreements”

I didn’t know that I would be enjoying my new part-time job as my father’s exercise coach, appointment escort, and advocate OR that I would be practicing The Four Agreements (from Don Miguel Ruiz’s timeless

Agreement #4 Always Do Your Best. Your best is going to change from moment to moment; it will be different when you are healthy as opposed to sick. Under any circumstance, simply do your best, and you will avoid self-judgment, self-abuse and regret….

From August to December of last year, I felt a great sense of accomplishment (after reading Dr. Norman Doidge’s book The Brain’s Way of Healing and learning how to ask Papa’s neurologist the right questions). Questions that led Dr. White to  order specific physical therapy to help Papa reverse the Parkinson’s “shuffling” gait and “freezing” gait as well as improve posture. Thank you, Dr. White!

Papa had learned new tricks (to retrain the brain) from Physical Therapist Brenda. I bragged about my being Papa’s exercise/walk coach.

During the same months, at my half-time day job, unbeknownst to me, my right hand was developing acute and chronic tendinitis. By mid-December my right wrist was in great pain, so much so that I was using my left hand for almost every task. Turning a key or a doorknob was asking for torture.

I no longer felt strong enough to “spot” Papa when he did his exercises. Thank goodness Papa’s new helper Mr. Chen walked with him and watched him exercise.

Over the next three months, I would still visit Papa and escort him to his appointments; however, instead of initiating “Papa, let’s walk stairs!” or “How about walking with walker down the block?” or “Show me your strengthening exercises,” I would ask him “May I watch ME TV channel?” Sitcoms like “Family Ties” (Michael J. Fox portrayed son Alex), “The Jeffersons” (Sherman Hemsley portrayed George) and “The Partridge Family” (Shirley Jones portrayed the mom) comforted me while a cold pack relieved pain and inflammation of my wrists.

On more than three occasions, I called Papa to cancel. I just did not feel well

It’s March (four months since Physical Therapist Brenda last saw Papa). She says: “Teresa, even though your father has been doing his exercises and he has good posture, his legs have gotten weaker and he has lost muscle mass.”  I want to cry.

The loving part of me says: “You have been showing up for Papa. You have to show up for yourself too.”

The judgmental part of me says: “You’ve been neglecting your duty as his exercise coach.”

Occupational Therapist/Hand Specialist Susan has taught me tricks to prevent re-injuring both thumbs and wrists. I too am exercising and healing.

It’s April. Wednesday evening I visited Papa. After we ate dinner (lamb and Chinese carrots over white rice for him; chicken meatballs and brocollini for me) and he watched news on a Chinese channel while I filled his pill boxes and updated his medical appointment list, I said, “Let me see your ‘fancy walk’ in the hallway.”

 

“Fancy walk” is:  his holding onto handrail with right hand; taking three steps forward (pick up feet); putting both hands on handrail to pivot (pick up feet); then, while holding onto handrail with left hand, take three steps backward (pick up feet); then putting both hands on handrail to pivot (pick up feet); repeat sequence until he gets to the end of the hallway. His legs tremor during pivoting; I say: “no hurry, pick up one foot.”

 

After that, we went downstairs to the mail room. Just a postcard for how to register to vote by mail. I said, “Let’s go to the lunchroom, slowly.” My heart was lifted seeing him pick up left foot, then right (his left leg is stronger than right). We walked through the lunchroom, down to the computer and stationary bike room. “Papa, why don’t you sit and rest? I’ll look at the birthday bulletin board.” To my surprise, he got onto one of the stationary bikes, put his feet into stirrups and began to peddle. I filmed him with my phone. Last year, he would have biked ten minutes. Tonight, three minutes. I felt happy – that he did not push himself.

Slowly we reversed our direction – down the hall, go through the lunchroom, and turn left.  As we neared the mailroom, he took his left hand off the rail and mildly swung his arms. “You go, Papa!”

He is doing his best.  I am doing my best.

To share your comments, please click on the blue title box on top of this blog post, then scroll down, fill in the boxes, and click “submit” . . .  Thank you so much!

 

For other posts in my blog, please go to: https://lovemadeofheart.com/blog

If you’re looking for my blog posts pertaining to our Beautiful Brains and Neuroplasticity… https://lovemadeofheart.com/blog  look at right side of screen, you’ll see the category “Beautiful Brains Neuroplasticity”.  Please click on that category to get those posts.

Author & Fanbase-Building Coach Teresa LeYung-Ryan says: “Reach out, not stress out. Enjoy your writer’s journey.”
http://WritingCoachTeresa.com

http://lovemadeofheart.com/blog/

https://www.youtube.com/user/teresaleyung

Teresa LeYung-Ryan is the author of:

·          Build Your Writer’s Platform & Fanbase In 22 Days: Attract Agents, Editors, Publishers, Readers, and Media Attention NOW (workbook);

·          Love Made of Heart: a Daughter Finds Herself Through Witnessing Her Mother’s Mental Illness (novel used in college classes, recommended by the California School Library Association and the California Reading Association, and archived at the San Francisco History Center);

·          “Talking to My Dead Mom” Monologues (the first monologue received an award from Redwood 10-Minute Play Contest and was staged at the 6th Street Playhouse in Santa Rosa, CA);

·         Coach Teresa’s Blog (which attracts tens of thousands of writers) at http://lovemadeofheart.com/blog/  helps writers build their platforms before and after publication

Teresa LeYung-Ryan is the creator and owner of the trademark LOVE MADE OF HEART

 

***

by Teresa LeYung-Ryan

This is 3 of 4 of my blog posts entitled “Parkinson’s Disease, My Chinese Papa, and My practicing The Four Agreements”

I didn’t know that I would be enjoying my new part-time job as my father’s exercise coach, appointment escort, and advocate OR that I would be practicing The Four Agreements (from Don Miguel Ruiz’s timeless book).

Agreement #3 – Don’t Make Assumptions

Extraordinaire Physical Therapist Brenda had taught my papa how to retrain his brain to turn Parkinson’s shuffling into “pick up foot” and “heel first, then toes” walking. Papa works hard at this.  He holds onto the handrails outside his apartment when he practices what I call “fancy walk.” However, when we leave the building with his walker, his walking regresses to shuffling. I assumed that Papa was uncooperative. That is until three days ago…when I put myself in his shoes.

[ According to http://www.parkinson.org/understanding-parkinsons/what-is-parkinsons/ Parkinson’s disease (PD) is a neurodegenerative brain disorder that progresses slowly in most people … a person’s brain slowly stops producing a neurotransmitter called dopamine. With less and less dopamine, a person has less and less ability to regulate their movements, body and emotions.]

If  Papa is pushing a walker (one type of movement), how does he concentrate on picking up his feet (another type of movement)? I asked Brenda to step out onto the sidewalk with us and teach new tricks.

She said to Papa: “Relax your arms on the walker. No need to strain yourself. Do concentrate on heel first with each step. I’ll put tennis ball slider feet on the rear legs of your walker to reduce the friction.”

This was Brenda’s last session in this round of physical therapy ordered by Papa’s neurologist. What other concerns to tell her?  Oh yes, Papa coughs when he takes his pills. Aiy yah. I assumed he was being Mr. Macho, downing four pills at the same time. Brenda had the answer. “Drinking water when taking pills, coughing?  Water is going down the wrong pipe. Add a thickening agent to liquids to reduce the risk of choking. And, sit in an upright position. Do NOT tilt head back.” I must ask her what kind of thickening agent.

[ According to https://www.michaeljfox.org/foundation/news-detail.php?swallowing-and-parkinson-disease ….  Difficulty swallowing, called dysphagia, can happen at any stage of Parkinson disease. Signs and symptoms can range from mild to severe and may include: difficulty swallowing certain foods or liquids, coughing or throat clearing during or after eating/drinking, and feeling as if food is getting stuck.  As the disease progresses, swallowing can become severely compromised and food/liquid can get into the lungs, causing aspiration pneumonia. Aspiration pneumonia is the leading cause of death in PD. [....]

Because Parkinson disease is progressive, swallowing abilities can change over time, underscoring the need for early intervention and frequent follow-up. Sometimes the signs of a swallowing disorder can be subtle, so it is important to be vigilant. If you think you have difficulty swallowing, ask your physician to refer you to a speech language pathologist for a swallowing evaluation.]

Gee, Papa is doing hard work. I’m very proud of him.  My practicing the four agreements is also hard work. I do believe that Mom is proud of me, and, if Papa knew how much I’m learning, he would be too.

To share your comments, please click on the blue title box on top of this blog post, then scroll down, fill in the boxes, and click “submit” . . .

 

For other posts in my blog, please go to: https://lovemadeofheart.com/blog

If you’re looking for my blog posts pertaining to our Beautiful Brains and Neuroplasticity… https://lovemadeofheart.com/blog  look at right side of screen, you’ll see the category “Beautiful Brains Neuroplasticity”.  Please click on that category to get those posts.

Thank you so much!

 

Author & Fanbase-Building Coach Teresa LeYung-Ryan says: “Reach out, not stress out. Enjoy your writer’s journey.”
http://WritingCoachTeresa.com

http://lovemadeofheart.com/blog/

https://www.youtube.com/user/teresaleyung

Teresa LeYung-Ryan is the author of:

·          Build Your Writer’s Platform & Fanbase In 22 Days: Attract Agents, Editors, Publishers, Readers, and Media Attention NOW (workbook);

·          Love Made of Heart: a Daughter Finds Herself Through Witnessing Her Mother’s Mental Illness (novel used in college classes, recommended by the California School Library Association and the California Reading Association, and archived at the San Francisco History Center);

·          “Talking to My Dead Mom” Monologues (the first monologue received an award from Redwood 10-Minute Play Contest and was staged at the 6th Street Playhouse in Santa Rosa, CA);

·         Coach Teresa’s Blog (which attracts tens of thousands of writers) at http://lovemadeofheart.com/blog/  helps writers build their platforms before and after publication

by Teresa LeYung-Ryan

This is 2 of 4 of my blog posts entitled “Parkinson’s Disease, My Chinese Papa, and My practicing The Four Agreements”

I didn’t know that I would be enjoying my new part-time job as my father’s exercise coach, appointment escort, and advocate OR that I would be practicing The Four Agreements (from Don Miguel Ruiz’s timeless book).

Agreement #2 – Don’t Take Anything Personally

Would you say that I ” took it personally” (in Blog Post 1 of 4)?

Well, here’s what happened this time… I escort Papa to his quarterly appointment with his podiatrist; Papa’s feet have diabetic nerve damage. The doctor’s assistant is named Geri; I tell her “What a lovely name, I know another Geri.”

I meet the podiatrist (male doctor) and give him a copy of the “After Visit Report” from Papa’s neurologist; I see him (podiatrist) reading the neurologist’s report that includes the recommendation  to continue Carbidopa/Levodopa (the drug that helps alleviate some of the Parkinson’s symptoms)

A minute later, the podiatrist is asking Papa: “You’re taking what I prescribed?  Gabapentin. No side effects?”

Papa looks confused.  The doctor writes a prescription refill and hands it to me. Then he proceeds with clipping my papa’s thick and discolored toe nails.

Later in the lobby while waiting for SF Yellow Cab, I tell Papa and his sweetheart Mary that I would gladly go to Target Pharmacy for him, to fill this prescription. Mary says in Cantonese “Don’t bother, he already takes too many pills.” Papa is nodding in agreement.

“Okay,” I say and I start for the elevator. “I’ll give back this prescription.”

“Don’t!” Mary leaps to her feet.  Papa looks agitated.

I’m raising my voice. “I told the doctor that I would fill the prescription. If I’m not going to, then I want to let him know that.”

Papa speaks in Cantonese: “He won’t like me if he knows I’m not taking his medicine.”

“You’re worried about being liked,” I snap. “Okay, it’s your life, not my business.”

Later, at my own home, I realized that I was taking it personally (not practicing Agreement #2) and getting upset with my father (not practicing Agreement #1).  Oh, Angel Mom, please give me strength.

The researcher in me wanted to know what the heck is Gabapentin. So,  I go to Mayo Clinic’s website.  According to:

http://www.mayoclinic.org/search/search-results?q=gabapentin

Gabapentin (Oral Route) is used to help control partial seizures (convulsions) in the treatment of epilepsy. This medicine cannot cure epilepsy and will only work to control seizures for as long as you continue to take it.

Gabapentin is also used in adults to manage a condition called postherpetic neuralgia, which is pain that occurs after shingles.

Gabapentin works in the brain to prevent seizures and relieve pain for certain conditions in the nervous system. It is not used for routine pain caused by minor injuries or arthritis. Gabapentin is an anticonvulsant.

This medicine is available only with your doctor’s prescription.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although this use is not included in product labeling, gabapentin is used in certain patients with the following medical condition:

  • Diabetic peripheral neuropathy.

WHY IS A PODIATRIST PRESCRIBING THIS DRUG WHEN PAPA’S DIABETES DOCTOR AND NEUROLOGIST ARE ALREADY PRESCRIBING OTHER DRUGS?

The next time I saw Papa, I apologized. Also, I composed a letter to his primary care physician and diabetes doctor, asking them for guidance.

Gee, practicing the four agreements is hard work.

To share your comments, please click on the blue title box on top of this blog post, then scroll down . . .  Thank you so much!

 

For other posts in my blog, please go to: https://lovemadeofheart.com/blog

If you’re looking for my blog posts pertaining to our Beautiful Brains and Neuroplasticity… https://lovemadeofheart.com/blog  look at right side of screen, you’ll see the category “Beautiful Brains Neuroplasticity”.  Please click on that category to get those posts.

 

Author & Fanbase-Building Coach Teresa LeYung-Ryan says: “Reach out, not stress out. Enjoy your writer’s journey.”
http://WritingCoachTeresa.com

http://lovemadeofheart.com/blog/

https://www.youtube.com/user/teresaleyung

Teresa LeYung-Ryan is the author of:

·          Build Your Writer’s Platform & Fanbase In 22 Days: Attract Agents, Editors, Publishers, Readers, and Media Attention NOW (workbook);

·          Love Made of Heart: a Daughter’s Journey Through Self-Forgiveness, Sparked by Her Mother’s Mental Illness (novel used in college classes, recommended by the California School Library Association and the California Reading Association, and archived at the San Francisco History Center);

·          “Talking to My Dead Mom” Monologues (the first monologue received an award from Redwood 10-Minute Play Contest and was staged at the 6th Street Playhouse in Santa Rosa, CA);

·         Coach Teresa’s Blog (which attracts tens of thousands of writers) at http://WritingCoachTeresa.com  helps writers build their platforms before and after publication


Dear Writers/Caregivers/Advocates for Loved Ones,

Coach Teresa LeYung-Ryan here . . .  I see how helping a loved one/being an advocate is so much like writing a book.

My papa has been diagnosed with Parkinsonism by his neurologist. If Papa is telling his story, he would be the first-person narrator; if I’m telling the story about him, then I would be the third-person narrator.

A book (story) consists of one main character (also known as “hero” or “protagonist”) or multiple main characters and other characters (other archetypes), a subject matter that is discussed repeatedly (“theme”) and at least one plotline (“what happened?”). The merging of these elements helps the writer show the hero’s journey.

Helping a loved one/being an advocate consists of at least 2 protagonists (YOU and the loved one) and other archetypes (physicians, healthcare and social service providers, other family members and friends, neighbors, coworkers, vendors, . . . the stranger who gives up her/his seat on the train for you), themes (the cause for help and advocacy and the related issues), and plotlines (the interconnected events associated with all the characters).  Who will be the most transformed in the story?  The loved one?  You the caregiver/advocate? The person who is most transformed would be the main character/hero/protagonist.  Perhaps both people will go through great transformation.  Two protagonists!

I am writing – I keep a notebook for whenever I visit my papa or when I do something on his behalf- gosh, there are so many little “subplots” to keep track of! (Is this Papa’s third or last session with the physical therapist? Mary and I need to witness the exercises so that when the P.T. closes the case, we would be able to coach Papa. Did he say he wanted another heating pad? Oh my, there are at least 18 model to choose from.   Gotta review friends’ advice about what is a comfortable bed and also Consumer Reports. Then Papa has to “test drive” some beds. You just can’t shop for a mattress the way you shop for a pair of shoes.

MATTRESS SHOPPING TIPS (from Sealy’s website)

  1. Plan to spend at least one hour in the store.
  2. Wear loose clothing and easily removable shoes.
  3. Test out mattresses in groups of three for easier comparison.
  4. Lie on each mattress for 5 to 15 minutes to let it fully adapt to your body.
  5. Don’t feel rushed. It’s ok to ask for privacy.

I would add:  Bring your own pillow so that your neck is supported while trying out mattresses; maybe bring an extra pillow case too.

And, I am reading the book The Brain’s Way of Healing: Remarkable Discoveries and Recoveries from the Frontiers of Neuroplasticity by Norman Doidge, M.D.  Chapter 2 is titled “A Man Walks Off His Parkinsonian Symptoms”  . . . how John Pepper has been able to reverse the major symptoms, the ones that Parkinson’s patients dread most, those that lead to immobility. He’s done so with an exercise program he devised and with a special kind of concentration . . .

All the “characters” in Dr. Doidge’s books (The Brain’s Way of Healing  and The Brain that Changes Itself: Stories of Personal Triumph from the Frontiers of Brain Science) and in Dr. Victoria Sweet‘s book (God’s Hotel: A Doctor, a Hospital, and a Pilgrimage to the Heart of Medicine) are guiding me on my journey as an advocate for my father.  And, I just know that my mom plays a huge role in helping me.

I thank everyone who has given me her/his time, energy, and prayers.

Here are links to websites I’ve relied on lately:

https://franceskakugawa.wordpress.com/category/caregiving/  Frances Kakugawa

http://www.writeradvice.com/ywmtdw.html  B. Lynn Goodwin

http://www.normandoidge.com/  Norman Doidge, M.D.

https://www.michaeljfox.org/  Michael J. Fox Foundation

Special thanks to Margie Yee Webb, Frances Kakugawa, Penny Manson, Debbie Ramos and her daughter Melanie who went out of their way to help me research specific items and to Mary, my sister Maria Leung, Linda Harris, Sue, Janet, and Elaine for being there in person.

Sincerely,

Writing Coach Teresa LeYung-Ryan

 

 

 

 

 

 

 

 

 

 

 

Author & Fanbase-Building Coach Teresa LeYung-Ryan says: “Reach out, not stress out. Enjoy your writer’s journey.”
http://WritingCoachTeresa.com

http://lovemadeofheart.com/

http://lovemadeofheart.com/blog/

https://www.youtube.com/user/teresaleyung

 

 

 

 

 

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